Bruxism

It’s the end of the day and your jaw is aching, all the way down the side of your neck and even down your back. Or it’s the morning, and the pops and clicks in your jaw as you brush your teeth seem to be getting worse. If either of these sound like a regular part of your day, chances are you have bruxism. Bruxism, also referred to as teeth grinding or clenching, affects an estimated 31% of people in the U.S. It’s also fairly common among children. Two or three children out of ten experience regular, reoccurring teeth grinding or jaw clenching.

What is bruxism?

Bruxism is an involuntary action of the jaw that comes in two forms: awake and sleep. Awake bruxism generally occurs during the day and may be more associated with jaw clenching. People who suffer from this form generally see their symptoms get worse as the day progresses.

Sleep bruxism is prevalent at night, with sufferers both clenching their jaw and grinding their teeth. Because of this, people with this condition often wake up with symptoms that diminish during the day.

Some people experience a combination of both sleep and awake forms, but this is rare.

How do you know if you have bruxism?

While a sore jaw and popping or clicking are common symptoms of this condition, they are not the only ones. Other bruxism symptoms include:

Uneven wear on the teeth: While a sufferer’s partner may initially notice the nighttime noise of teeth grinding, a dentist may also see uneven wear patterns on the biting surfaces of teeth.

Head and neck pain: The muscles of the jaw are intricately connected to the neck and even shoulder muscles. Constant muscular engagement in the jaw can lead to headaches as well as neck and shoulder pain.

Limited range of motion: Those who suffer from sleep bruxism may have trouble opening their mouth or moving their jaw from side-to-side when they wake up.

Fractured or broken teeth or loose teeth: Constant pressure on the teeth can cause small fractures and even broken teeth over time. This can occur in dental restorations as well. Over time, this pressure can also cause teeth to become loose.

Increased sensitivity to hot and cold: When the worn enamel and tooth material begins to expose the soft dental pulp of the tooth, sufferers may find themselves more sensitive to hot and cold on their teeth.

Pain in the ligaments of the jaw: Over time, the muscles of the jaw and neck aren’t the only painful location. As the ligaments of the jaw become stressed, inflammation and swelling can lead to pain in the temporomandibular joint itself.

Swelling on the face: As the condition progresses and inflammation increases, swelling at the joint may become visible. The skin may be slightly red and even warm to the touch.

What causes bruxism?

There are many different causes of this condition in both adults and children.

Medications

Because bruxism is related to disturbances in the central nervous system (CNS), it stands to reason that any medication that affects the CNS would affect the incidence of tooth grinding. Changes to the dopaminergic system, the neurotransmitters in the central nervous system that regulates the release of dopamine, may result in an increase in symptoms.

Stress and anxiety

A common cause of awake bruxism is stress, but those with sleep symptoms may carry their day with them as they sleep. Stress can trigger an involuntary clenching response in the jaw. Women tend to experience more awake bruxism than men. This is potentially due to their higher rates of stress and more frequent diagnosis of anxiety.

Anxiety is a common cause of this condition in children as well.

Sleep apnea

Sleep apnea is closely linked to bruxism. This condition causes the sleeper to stop breathing up to ten times an hour, all night long. It’s typified by an involuntary gasp of awakening. This can be accompanied by a period of jaw clenching and teeth grinding.

It is unclear whether sleep apnea leads to this condition or vice versa, but they are both closely linked to involuntary actions in the central nervous system (CNS).

Poor bite alignment

Especially for children, poor bite alignment can cause bruxism.

People who experience pain due to improperly aligned teeth may grind their teeth as pain levels fluctuate overnight. Many children will grow out of this as the bite changes, but for some the problem persists into adulthood.

How to stop bruxism?

To treat painful inflammation and muscle soreness, a common bruxism treatment is non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and a cold compress for the swelling. There is no real “cure” for this condition. However, there are bruxism treatments that can help limit the amount of grinding and clenching.

Bruxism appliances and guards

Dental appliances and bruxism mouthguards work to protect the surfaces of the teeth from wear while gently repositioning the jaw.

Botulinum toxin A (Botox) has been recently used as a bruxism treatment, with mixed results. In theory, this injection helps to relax jaw muscles just enough to prevent tooth grinding but not so much that it interferes with eating or talking.

The most successful treatments occurred on otherwise healthy patients with no underlying bone loss in the jaw. The research is limited and may not be comprehensive enough to recommend Botox as a treatment for patients who haven’t attempted more conservative treatments yet.